Director Health Plan Underwriting - REMOTE

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Director Health Plan Underwriting - REMOTE

Job Description

The Director of Health Plan Underwriting is responsible for leading the Underwriting team responsible for providing information, analyses, and RFP support for the organization to develop recommendations for pricing terms and structure. This position is responsible for providing overall direction and leadership to the underwriting teams, which includes oversight of health plan strategies for all lines of business. The Director is also responsible for serving as an expert consultant on matters pertaining to underwriting, performance guarantees, margin, and other financial considerations that impacts a PBM offering.

Responsibilities

• Provides both strategic direction and day to day guidance to a team of underwriters and managers, to maintain expert underwriting support and meet the needs of the organization
• Works with client engagement teams to develop, drive, and execute pricing and margin strategies
• Oversees and coordinates workflow for the underwriting team
• Works with proposal unit to ensure responses, including pertinent definitions and caveats, for the financial responses to all RFPs are complete and accurate
• Consults with Legal and Client Engagement to ensure, contractual deal terms, caveats, and other pertinent information is accurate and supports the deal as underwritten
• Assists with client contract negotiations as needed
• Engages in client and external consultant engagements to demonstrate Prime's value proposition
• Responsible for ensuring standard operating procedures are adhered to and that all bids are properly tracked and documented
• Collaborate with management on staffing plans, productivity metrics and initiatives to improve efficiencies within the department
• Other duties as assigned

Minimum Qualifications

• Bachelor's degree in Mathematics, Accounting, Finance or related are of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• 8 years of related experience and/or training
• 5 years of leadership/people management experience
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• In-depth knowledge of mathematical applications used in underwriting function including the ability to calculate figures such as discounts, proportions and percentages, as well as the ability to apply basic concepts of business mathematics and algebra in underwriting problems
• Exceptional communication skills; ability to distill complex material into easy to understand presentations, effectively respond to questions and engage a variety of audiences
• Strong team player with a customer service approach
• Ability to effectively communicate with Senior Leadership Team and Executive Leadership Team. Presents recommendations to Executive Leadership on new pricing methodologies and follows through on execution of key strategies
• Ability to persuade and influence executive leadership at Prime, current Blue and prospective Blue plans with key initiatives to support margin and growth objectives for the self-insured pharmacy market
• Ability to negotiate with difficult external audiences and partners to support Prime and Blue plan objectives

Preferred Qualifications

• 3 years of experience as an Underwriting Manager with PBM experience

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.  

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.